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INTRODUCTION METHODS

Highvolumein-linewatersamplingusingIDEXXFilta-maxxpress®modulesandsamplingofbackwashwaterforcryptosporidiumtesAng

RESULTS

DISCUSSION CONCLUSIONS ACKNOWLEDGEMENTS

REFERENCES

Approximate location of pools participating in the study

Poolsidesamplingforbacterialindicatorsandchemicalparameterswasundertakenonsiteatthepoolside,includingpH,chlorinelevelsandturbidity

Cryptosporidiumcausesdiarrhoealdisease(cryptosporidiosis)withsome6000confirmedcasesintheUKeachyear.Cryptosporidiosiscanbecontracteddirectlythroughcontactwithaninfectedpersonoranimalandafaecaloralrouteorviaconsumingcontaminatedfoodand/orwater.MostoutbreaksofCryptosporidiosisarehoweverassociatedwithrecreaConalwaterexposure,inparCcularswimmingpools,includingleisurepools.TheCryptosporidiumoocystsareresistanttorouCnechemicaldisinfecConinswimmingpoolsandpresentchallengestoswimmingpoolmanagement.CryptosporidiumisnottestedforrouCnelyinpools;it’sdifficultandexpensivetotestfor,notalllaboratoriesareaccreditedtocarryoutthetestsandtherearenoquanCtaCvestandards,ordataareavailablefortheUK.TesCnginoutbreaksrequiresverycarefulconsideraCon,includingtheinterpretaConofresultstakensomeCmeaKerapotenCalwatercontaminaConincident.PrimaryAim;•  Undertakealongitudinalsamplesurvey,over10weeksduringsummerandautumn2017,toesCmatethe

backgroundoccurrenceandconcentraConofCryptosporidiuminsixUKleisurepools.SecondaryAims•  toinformguidanceforpooloperators•  toprovidedataforquanCtaCvemicrobialriskassessment•  improvesamplingcapacity,capabilityandinterpretaConforpublichealthinvesCgaCons

PoolsTested6volunteerfree-formleisurepoolswithfeatures:slides,wavemachinesand/orlazyriversvolunteeredtosupportthestudyandsubmitsamples4ofthepoolsweresituatedincommunityleisurecentres,2poolswereatlargeresidenAalholidayparksSamplingrigswereinstalledtoallowthefiltraConofhighvolumewatersamplesfromeachpoolovera10weekperiodfromearlyAugust2017SampleswerealsotakenandsubmiTedforrouCnemicrobiology.PoolsidetestsforchemicalparameterswerealsocarriedoutandsubmiTedaspartofthestudyPublicHealthResponseandPlanningBeforecommencingthestudyaprotocolwiththeLocalAuthorityandHealthProtecConTeamwereagreedforeachsite.

EachpooldevelopedconCngencyplansforposiCvesamplesandadverseeventsduringtheproject.Apre-samplingreviewwasalsocarriedoutonsitebyeachLocalAuthoritypriortotheproject.www.publichealthwales.org/cryptopoolguidance/

PoolWaterSamplesPoolwatersamplevolumesthroughtheIDEXXFilta-Maxxpress®were60to999L,median493LSamplesweretakenover8to24hoursIDEXXFilta-Maxxpress®filterscanblockevenwhenturbidityissaAsfactoryOocystsweredetectedin12/59(20%)samples,countsrangedfrom0to0.116oocysts/L.8/12(66%)detecAonswereinAugustwhenbatherloadswerehighestFilterBackwashWaterFilterbackwashwaterwassampledfrom3pools.Oocystsweredetectedin2/29(7%)samples,from2pools;countswere1and4oocysts/L.DetecAonscoincidedwithoocystcountsinpoolwaters.

TesAngforRouAneIndicatorsColonycountsoftotalcoliforms,Escherichiacoli,andPseudomonasaeruginosain59/60sampleswere

allzero(1sampleinvalidhavingbeensenttothewronglaboratory)Aerobiccolonycounts@37oCfor24hin57sampleswere:

SaCsfactory(≤10cfu/ml)41(72%)samplesConcerning(10-100cfu/ml)4(7%)samplesUnsaCsfactory(>100cfu/ml)12(21%)sample

3sampleswereinvalid(1senttowronglab;2arrived>24haKersampling)ACCfailuresandCryptosporidiumdetecAonswereNOTrelated

ThisprojectwascarriedoutwiththesupportandcooperaConofcolleagueswithinpublichealth,tesCnglaboratories,recreaConalwaterprovidersandwithsignificantsupportandinputfromthePoolWaterTreatmentAdvisoryGroup.TheprojectwaslimitedintermsofthestudyCme,thenumberofparCcipaCngpoolsandtheconfiguraConofthepools,buttargetedthepooltypeandspannedtheseasonmostrelevanttopool-relatedincidents.TheresultsservetoinformonacConsthatcanbeconsideredinresponsetoapublichealthincidentandinresponsetoanyposiCveresultsfromanysamplingcarriedoutforCryptosporidiumand/orindicatororganisms.ThesedatashouldbesupplementedforquanCtaCvemicrobialriskassessmentisrequiredtofurtherdevelopresponses.ThisrequirescollaboratorsandfundingtocollectbatherbehaviourdataforUKandundertakeanalysis

TheriskofdetecConofCryptosporidiumoccurredwhenbatherloadswerehighest.PoolwatermanagementisthereforecriCcalattheseCmes.CryptosporidiumdetecConsandACCfailureswerenotlinkedinthepproject.Nevertheless,samplingforindicatorsorganismscanconCnuetogivesuretyandverificaConofgeneralwatermanagement.SmallnumbersofCryptosporidiumoocystsdetectedinswimmingpoolscanbesuccessfullymanagedbyadheringtoPWTAGstandards;thisalsoincludesensuringpoolwaterchemistryismonitoredandpoolplantandequipmentismaintained.Accesstosamplingparaphernaliaincludingliaisonwithaccreditedlaboratories,anddevelopinganevidencebaseforenvironmentalcryptosporidiaisessenCaltosecuringeffecCveresponsetoincidentsImprovedsamplingcapacity,capabilityandinterpretaConforpublichealthinvesCgaConsisrequired.

1.Anon.TheMicrobiologyofDrinkingWater–Part14-MethodsfortheisolaCon,idenCficaConandenumeraConofCryptosporidiumoocystsandGiardiacysts2.Anon(2010)TheMicrobiologyofDrinkingWater–Part2–PracCcesandproceduresforsampling;EnvironmentAgency3.TheMicrobiologyofDrinkingWater(2012).Part7–MethodsfortheenumeraConofheterotrophicbacteria.EnvironmentAgency4.TheMicrobiologyofDrinkingWater(2015).Part8-MethodsfortheisolaConandenumeraConofAeromonasandPseudomonasaeruginosa5.TheMicrobiologyofDrinkingWater(2016).Part4-MethodsfortheisolaConandenumeraConofcoliformbacteriaandEscherichiacoli6.Anon(2017).SwimmingPoolWater3rdEdiConPoolWaterTreatmentAdvisoryGroup,Tamworth

The Occurrence of Cryptosporidium in Pools Project, UK, Summer, 2017

Rachel Chalmers, Project Manager, Cryptosporidium Reference Unit , Public Health Wales     

Rob Johnston, Food Water and Environmental Microbiology Laboratories, Public Health England

Megan Luxford, IDEXX, Newmarket Cambs. Rob Miller, LATIS Scientific, Crayford, Kent, UK

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2018

Highvolumesamplingrig

Laboratoryprocessing(IDEXX)toeluteandconcentrateoocysts

Cryptosporidiumoocystcountsbymicroscopy Poolsidesamplingfor

rouAneindicatorsLaboratoryculture(LaAsScienAfic)

TesAngforchemicalparameters,poolside

PoolWaterTreatmentAdvisoryGroup,(PWTAG),UKIDEXX,Newmarket,Cambs,UKLaCsScienCfic,Crayford,Kent,UKCerCkin,HowardGosling,TotalPoolChemicalsLtdandJasonBasseTTCSBioSciencesLtd:ColorSeedTintometerLtd:hand-heldandin-lineturbiditymetersBourneLeisure,headofficeHemelHempstedSwanseaLeisureCentre,Swansea,WalesMerthyrLeisureCentre,Merthyr,WalesSercoLeisure,operatorsforMansfieldDCWaterMeadowsPerthLeisurePool,Perth,ScotlandLocalauthoriCesandHealthProtecConTeams